正常月经周期体外受精-胚胎移植术女性卵巢基础内分泌水平与妊娠结局的关系  

Relationship between basal ovarian endocrine level and pregnancy outcomes in women with normal menstrual cycle vitro fertilization and embryo transfer

作　　者：苗瑛铭 李珑 MIAO Ying-ming;LI Long(Hainan Medical University,Haikou 570311,China;Department of Gynecology,the Second Affiliated Hospital of Hainan Medical University,Haikou 570311,China)

机构地区：[1]海南医学院,海口570311 [2]海南医学院第二附属医院妇科,海口570311

出　　处：《中国医学前沿杂志（电子版）》2020年第1期97-100,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：2018年海南省重点研发计划(ZDYF2018145)。

摘　　要：目的探讨正常月经周期体外受精-胚胎移植术(in vitro fertilization and embryo transfer,IVF-ET)女性卵巢基础内分泌水平与妊娠结局的关系。方法回顾性分析2018年1月至2018年12月于海南医学院第二附属医院接受IVF-ET治疗的296例女性的临床资料,根据妊娠结局将其分为妊娠组(102例)和未妊娠组(194例),比较两组女性基础血清雌二醇(estradiol,E2)、卵泡刺激素(follicle-stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)、抗米勒管激素(anti-Müllerian hormone,AMH)水平、FSH/LH比值、年龄、平均卵巢体积、窦状卵泡数的差异性,并对上述指标与IVF-ET女性妊娠结局的关系进行多元Logistic回归分析。结果妊娠组女性基础血清E2、FSH、LH水平和FSH/LH比值均显著低于未妊娠组(均P<0.05),AMH水平显著高于未妊娠组(P<0.05),年龄显著小于未妊娠组(P<0.05),卵巢体积显著大于未妊娠组(P<0.05),窦状卵泡数显著多于未妊娠组(P<0.05)。多元Logistic回归分析显示:年龄、卵巢体积、FSH和LH水平、FSH/LH比值均是预测IVF-ET女性妊娠结局的独立指标(均P<0.05),其中,FSH预测妊娠结局的曲线下面积和敏感性最高,上述5项指标联合预测的价值高于单一指标预测。结论IVF-ET女性的妊娠结局与年龄、卵巢体积、FSH和LH水平、FSH/LH比值密切相关,5项指标联合检测的预测价值更高。Objective To explore the relationship between basal ovarian endocrine level and pregnancy outcomes in women with normal menstrual cycle in vitro fertilization and embryo transfer(IVF-ET).Method The clinical data of 296 women who received IVFET in the Second Affiliated Hospital of Hainan Medical University from January 2018 to December 2018 were analyzed retrospectively.According to the pregnancy outcomes,the selected women were divided into pregnancy group(n=102)and non-pregnancy group(n=194).The levels of basic serum estradiol(E2),follicle-stimulating hormone(FSH),luteinizing hormone(LH),anti-Müllerian hormone(AMH),FSH/LH ratio,age,mean ovarian volume and antral follicles number were compared between the two groups.Multivariate Logistic regression analysis was performed on the relationship between the above indicators and pregnancy outcomes of IVF-ET women.Result The serum levels of E2,FSH,LH and FSH/LH ratio in pregnancy group were significantly lower than those in non-pregnancy group(all P<0.05),the AMH level was significantly higher than that in non-pregnancy group(P<0.05),age was significantly lower than that in non-pregnancy group(P<0.05),the average ovarian volume was significantly larger than that in non-pregnancy group(P<0.05),and the number of antral follicles was significantly higher than that in non-pregnancy group(P<0.05).Multivariate Logistic regression analysis showed that age,ovarian volume,levels of FSH and LH and FSH/LH ratio were independent predictors of pregnancy outcomes in women with IVF-ET(all P<0.05).And the area under the curve(AUC)and sensitivity of FSH in predicting the pregnancy outcomes were the highest,and the value of the combined prediction of the above five indicators was higher than that of the single index.Conclusion The pregnancy outcomes of women with IVF-ET are closely related to age,ovarian volume,levels of FSH and LH and FSH/LH ratio,and the combined detection of these five indexes has the higher predictive value.

关 键 词：体外受精-胚胎移植术 月经周期 卵泡刺激素 黄体生成素 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]